Lipoprotein apheresis for anti-nephrin antibody-positive steroid-resistant nephrotic syndrome: a pediatric case report - PubMed
5 hours ago
- #Lipoprotein Apheresis
- #Pediatric Nephrology
- #Anti-nephrin Antibody
- Report presents a 7-year-old male with steroid-resistant nephrotic syndrome (SRNS) positive for anti-nephrin autoantibodies (ANABs).
- Patient was unresponsive to multiple therapies including tacrolimus, rituximab, mycophenolate mofetil, and therapeutic plasma exchange.
- Compassionate-use lipoprotein apheresis (12 sessions over 10 weeks) led to a marked decrease in ANAB titers and clinical improvement.
- Improvements included increased urine output, resolution of edema, and discontinuation of ultrafiltration, though nephrotic-range proteinuria persisted.
- Case suggests lipoprotein apheresis may have immunomodulatory effects, possibly removing antibodies or immune complexes more efficiently than plasma exchange.
- Serial ANAB monitoring served as a biomarker correlating with treatment response; controlled studies are needed to define its role in ANAB-positive SRNS.